An Informal School-based, Peer-led Intervention for Prevention of Tobacco Consumption in Adolescence: A Cluster Randomized Trial in Rural Gandhinagar

Anjali Sunil Kumar Mall, Aroor Bhagyalaxmi, Anjali Sunil Kumar Mall, Aroor Bhagyalaxmi

Abstract

Background: Tobacco use among adolescence is one of the important preventable causes of death as well as a leading public health problem all over the world. The present study was conducted with the objective of studying the effect of peer-led interventions on tobacco use among adolescents.

Materials and methods: Twenty schools were randomly selected and ten schools each were identified as cluster for intervention and control groups. A total of 402 students in intervention group and 422 in control group were studied.

Results: About 48% and 41% of adolescents were consuming smokeless tobacco in any form in the intervention and control groups, respectively. Prevalence of consumption of smokeless tobacco was significantly high among boys as compared to girls. Pan masala was the most common form of consumption. After conducting A Stop Smoking in School Trial-like peer-led intervention, a significant reduction in tobacco consumption of any form was observed in the intervention group (48%-36%) during the follow-up (Z = 3.2, P < 0.01). A significant reduction in exposure to passive smoking in the intervention group (32%-29%) was also observed. All the students smoking initially had stopped smoking at the end of the follow-up in both the groups.

Conclusion: It was found that peer-led intervention was effective in reducing the consumption of smokeless tobacco in any form. The rate of reduction was more in the first follow-up as compared to the end of the intervention. Sustained intervention in the form of retraining is needed for the long-term effect.

Keywords: Adolescents; smokeless; smoking; tobacco.

Conflict of interest statement

There are no conflicts of interest.

References

    1. United Nations Population Fund India. A Profile of Adolescents and Youth in India. Ch. 2. Size, growth rate and distribution of adolescent and youth population. UNFPA. 2014. [Last accessed on 2017 Jul 10]. pp. 7–8. Available from: .
    1. Mihir NS, Bimal SJ. Global Youth Tobacco Survey: Fact Sheet – India-Ahmedabad City & Gujarat State Report (GYTS 2003) 2003:26–8.
    1. Shafey O, Eriksen M, Ross H, Mackay J, editors. The Tobacco Atlas. 3rd ed. Atlanta: The American Cancer Society; 2009.
    1. World Health Organization. Tobacco Deadly in Any Form: WHO. 2006. [Last accessed on 2016 Jun 28]. Available from: .
    1. Chaudhry K. Is pan masala-containing tobacco carcinogenic? Natl Med J India. 1999;12:21–7.
    1. Chadda R, Sengupta S. Tobacco use by Indian adolescents. Tob Induc Dis. 2002;1:111–9.
    1. John RM, Sung HY, Max W. Economic cost of tobacco use in India, 2004. Tob Control. 2009;18:138–43.
    1. Poland B, Frohlich K, Haines RJ, Mykhalovskiy E, Rock M, Sparks R. The social context of smoking: The next frontier in tobacco control? Tob Control. 2006;15:59–63.
    1. Harden A, Oakley A, Oliver S. Peer-delivered health promotion for young people: A systemic review of different study designs. Health Educ J. 2001;60:339–53.
    1. Andrey S, Cordall K, Moore L, Cohen D, Campbell R. The development and implementation of a peer led intervention to prevent smoking among secondary school students using their established social networks. Health Educ J. 2004;63:266–84.
    1. Campbell R, Starkey F, Holliday J, Audrey S, Bloor M, Parry-Langdon N, et al. An informal school-based peer-led intervention for smoking prevention in adolescence (ASSIST): A cluster randomised trial. Lancet. 2008;371:1595–602.
    1. Subba SH, Binu VS, Menezes RG, Ninan J, Rana MS. Tobacco chewing and associated factors among youth of Western Nepal: A cross-sectional study. Indian J Community Med. 2011;36:128–32.
    1. Arora M, Tewari A, Tripathi V, Nazar GP, Juneja NS, Ramakrishnana L, et al. Community-based model for preventing tobacco use among disadvantaged adolescents in urban slums of India. Health Promot Int. 2010;25:143–52.
    1. Patel DR. Smoking and children. Indian J Pediatr. 1999;66:817–24.
    1. Goenka S, Tewari A, Arora M, Stegler MH, Perry CL, Arnold JP, et al. Process evaluation of a tobacco prevention program in Indian schools-methods, results and lesson learnt. Health Educ Res. 2010;25:917–35.
    1. Perry CL, Stigler MH, Arora M, Reddy KS. Prevention in translation: Tobacco use prevention in India. Health Promot Pract. 2008;9:378–86.
    1. Klepp KI, Halper A, Perry CL. The efficacy of peer leaders in drug abuse prevention. J Sch Health. 1986;56:407–11.
    1. Cuijpers P. Effective ingredients of school-based drug prevention programs. A systematic review. Addict Behav. 2002;27:1009–23.
    1. Hunt MK, Fagan P, Lederman R, Stoddard A, Frazier L, Girod K, et al. Feasibility of implementing intervention methods in an adolescent worksite tobacco control study. Tob Control. 2003;12(Suppl 4):IV40–5.

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